Orthopedic conditions like arthritis, joint issues, back pain, and chronic pain affect an estimated 126.6 million Americans, twice the number of Americans living with chronic heart or lung conditions.1
With the advancements being made in healthcare technology, it’s surprising that the results of surgeries for orthopedic issues aren’t improving. Often, after surgery, the pain comes back or potentially worsens. This is due to several factors including the weight of the patient, where the issue resides, and what the X-ray shows versus the true root cause of the pain. Usually, the best way to find relief from orthopedic issues is through physical therapy and weight monitoring. In many cases, the solution to the problem is simpler than you think.
People need to be looked at from a whole, not just where their pain resides, to be correctly diagnosed and treated.
According to sports medicine physician and member of the Best Doctors network of expert physicians, Dr. John Mayhew, the source of the problem is often surgeons who decide to operate on patients based strictly on the findings from an X-ray or MRI.
“The X-ray or scan makes the diagnosis, but the decision for surgery needs to be based on a patient’s symptoms,” says Dr. Mayhew. “Are we actually going to improve their quality of life? Not just make the X-ray look better.”
This makes it more important than ever to weigh the pros and cons of surgery for treating an orthopedic condition, especially when a non-surgical treatment may be just as effective in bringing about a positive outcome. In the most troubling cases, patients end up undergoing unnecessary procedures that leave them no better, or worse off, than before.
In the United States, unnecessary surgeries might account for 10% to 20% of all operations in some specialties—this figure includes many spinal surgeries and knee replacements. According to one report, about 10% of all spinal fusions paid for by Medicare in 2011 were unnecessary.
A study published in the journal Surgical Neurology International evaluated 274 patients with neck and back complaints over a one-year period and found more than 17% had been told they needed surgery when there was no evidence to indicate an operation was necessary.2
Dr. Mayhew cites the use of arthroscopic surgery (a procedure that involves inserting a small camera inside the joint) to treat osteoarthritis of the knee as an example of a procedure that is overused, sometimes with negative consequences.
“It’s been shown that arthroscopy of the knee for osteoarthritis is a bad operation and it actually makes people worse,” says Dr. Mayhew, adding that he treats his own patients based on their symptoms, not just on what the X-ray shows.
According to Dr. Mayhew, physicians should first look at non-surgical ways of treating an orthopedic condition. This is especially important considering that surgical intervention comes with several risks, including pulmonary embolism, deep vein thrombosis, and post-operative infections.
“We should be using physical therapy, weight loss, bariatric surgery, and injection-type therapies rather than orthopedic surgery at times,” he says.
Several other orthopedic conditions can be successfully treated without surgery, often leading to better patient outcomes. One example is Achilles tendon rupture. “The available evidence now says that non-surgical treatment of that is as good as, if not better than, surgical treatment,” says Dr. Mayhew.
Whether you’ve received a difficult diagnosis, have doubts about a treatment, question the need for surgery, or don’t think there’s a solution to your chronic pain, your Best Doctors medical specialists can help. There should always be a clear answer to the pain you experience, and sometimes it just takes the opinion of a medical expert who specializes on your condition to bring clarity on the best decision for your health.
You have Best Doctors through your employer or insurance provider at no cost to you. It’s confidential, completed virtually (so you don’t have to travel), and provides peace of mind on your diagnosis. Getting a specialist’s opinion could change your life. If you have any medical doubt, start a case today.
Seventy-nine percent of our members had their treatment modified after using the Expert Medical Opinion service.
1https://www.boneandjointburden.org/docs/The%20Burden%20of%20Musculoskeletal%20Diseases%20in%20the%20United%20States%20(BMUS)%203rd%20Edition%20(Dated%2012.31.16).pdf
2https://www.usatoday.com/story/news/nation/2013/06/18/unnecessary-surgery-usatoday-investigation/2435009/
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